Individual
MRS. DENISE RAY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
8057 GLENGARRIFF RD, CLEMMONS, NC 27012-8830
(336) 712-4257
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
107350
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
081860
NC
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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